功能性药物洗脱支架对冠状动脉介入治疗后内膜增生及TFPI-2的影响
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中国医师协会阳光心血管研究基金(SCRFCMDA201316)资助;浙江省自然科学基金(LY14H020006)资助


The Effect of Functional Drug-eluting Stent on Intimal Hyperplasia and TFPI-2 After PCI
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    摘要:

    目的 探讨新型双面复合药物涂层支架体内抑制血管平滑肌细胞增殖及促进内皮修复的作用。方法65只中华小型猪非高脂饮食喂养4周,随机分为假手术组、球囊损伤+双面涂层支架植入组和球囊损伤组,造模后继续喂养4周,抽血检查血浆TFPI-2水平,行冠状动脉OCT检查后处死并取冠状动脉血管组织行分子生物学检测。结果 OCT图像可见球囊损伤组斑块明显扩大,内膜增厚,纤维帽厚度明显增加,假手术组基本正常,支架植入组居中;内膜/中膜面积比球囊损伤组(2.23±0.72),支架植入组(2.01±0.56)稍高于假手术组(1.89±0.27);内膜/中膜厚度比分别为球囊损伤组(2.12±0.74),支架植入组(1.74±0.66)与假手术组(1.52±0.47)。支架植入组较球囊损伤组下降,差异有统计学意义(P<0.05)。假手术组、支架植入组、球囊损伤组三组血浆TIFI-2水平分别为135.2±22.6 μg/L、127.2±23.4 μg/L和52.4±22.6 μg/L前两组基本相仿,但球囊损伤组明显下降,差异有统计学意义(P<0.01)。假手术组、支架植入组、球囊损伤三组TIFI-2与β-actin比值分别为2.45±0.22、2.22±0.26、1.27±0.33、TFPI-2在正常动脉血管组织中较少表达,支架植入组表达水平与假手术组比较差异无显著性(P>0.05),而球囊损伤组则表达明显下降,差异有统计学意义(P<0.01)。结论 双面药物涂层支架较球囊损伤组比较能降低血管内膜增生;同时促进冠状动脉内膜表达TFPI-2,血浆TFPI-2水平升高,进而可能减少支架内血栓的形成。

    Abstract:

    Aim To investigate the efficacy of the double coated compound drug-eluting stent of As2O3 and CD133+antibody to repair vascular endotelium and prevent smooth musle cell poliferation. Methods 65 China miniature pigs were fed with no-fat diet for 4 weeks, then divided into 3 groups: sham group, stent implantation group, ballon injury group. Four weeks later, coronary evaluting with OCT was performed, the plasma TFPI-2 level was checked and coronary artery tissue was used for immunohistology analysis. Results The OCT images showed that the coronary plaque enlarged significantly,endothelium and fibrous cap obviously thickened in ballon injury group, and the sham group was normal,the group B was found between the two. The coronary intima/media thickness ratio was 2.12±0.74 in balloon group,1.74±0.66 in stent implantation group and 1.52±0.47 in sham group. Intima/media area ratio was 2.23±0.72 in balloon group, 2.01±0.56 in stent implantation group and 1.89±0.27 in sham group . The plasma TFPI-2 level: sham group, stent implantation group, ballon injury group was 135.2±22.6 μg/L,127.2±23.4μg/L,52.4±22.6 μg/L respectively The sham group and stent implantation group were similar, but the balloon injury group were significantly decreased, the difference was statistically significant (P<0.01). Western blot results: TIFI-2 and β -actin ratio of group sham group, stent implantation group, ballon injury group were 2.45 ± 0.22, 2.22 ± 0.26, 1.27 ± 0.33 respectively TFPI-2 in normal arterial tissues expressed less The expression level of TFPI-2 in double coated compound drug-eluting stent and sham group were similar with no significant difference (P>0.05). Balloon injury group expression was significantly decreased, the difference was statistically significant (P<0.01). Conclusion The double coated compound drug-eluting stent could promote the endothelium to produce TPFI-2,enhance the plasma TFPI-2 level, and then reduce the formation of stent thrombosis in possible. Otherwise,it could decrease in-stent intimal hyperplasia.

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高学忠,阿米娜·马合木提,黄隐青,张 鑫,黄明远,吴连拼.功能性药物洗脱支架对冠状动脉介入治疗后内膜增生及TFPI-2的影响[J].中国动脉硬化杂志,2014,22(11):1101~1104.

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  • 收稿日期:2014-07-15
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